ComplaintsforKaiser Permanente

• Initial Complaint

  05/19/2023

  Complaint Type:

  Order Issues

  Status:

  Unanswered

  More info

  Kaiser has gone downhill the last five years. Their level of care is more focused on their contracts and what money they can take rather than the patient’s health. I use a CPAP machine and I have had a horrible interactions and dealings with ***** but Kaiser refuses to allow me to get my materials from ******* on medical who does get me my stuff. It doesn’t bill me for things they never delivered or make me sit on the phone for hours and then lie about it. Apria claims they called me recently and they did not. Kaiser does not follow up. Kaiser canceled my order that I had with ******* Home medical and I’ve been using the same hose, and same mask for nearly a year now. It has a tear in the mask and I’m getting illnesses from the mask. Kaiser does not care. I’ve had people put in referrals for ******* home medical, but Kaiser keeps canceling them. I am absolutely furious because this has happened more than three times, and they refused to listen. They refused to listen to the patient’s care that they would like and instead trying to focus on some stupid contract that they have instead of helping people get better. They ignore the patients. They don’t care about the patients. In the last five years, Kaiser‘s service has gone massively downhill. They raise the prices of tests and medication’s, but God forbid you need supplies and they’ll tell you know. I’m so sick and tired of this company. I’m so sick and tired of the way they treat people. Somebody really needs to look into this company because it’s shady business dealings. I want my freaking hose, masks, filters, and everything else. I want my year supply, because God knows they’ll never do anything else. I want to speak to the head of Kaiser Permanente, and I wanna speak to the head of the eastern coast of Kaiser Permanente. Enough of these games. I do not want to have any interaction with ***** whatsoever. I don’t want to be getting supplies from them. ******* home medical only.

• Initial Complaint

  03/22/2023

  Complaint Type:

  Billing Issues

  Status:

  Unanswered

  More info

  We made a payment for a healthcare bill from Kaiser on July 12, 2022, in the amount of $1893.94 from my wife's *************/********* HSA account. The payment never posted to our Kaiser account. We followed up and provided them with the proof of the transaction (provided to us by ************) via fax in September 2022. We did so again in November, December, and January. The most recent was a fax on March 10, 2023. We have never once received a call, email, or letter about it. Every attempt from us to follow up results in the same, "we will look into it. Give us a call next week." For six months. Kaiser states that the Lost Payment Department does not have a telephone number so we never actually speak with anyone other than a regular customer service representative. That rep usually ends up speaking to a supervisor, who then tells them they will look into it and we should call back. We have never been allowed to speak to a supervisor. They owe us $1893.94 and are non-responsive, so we are at a loss as to what to do here. The most recent fax is attached. Sincerely, *******************

• Initial Complaint

  03/06/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My name is *********************. I have been dealing with Crohns Disease since the age of 16, and was diagnosed by a professional gastroenterologist at Kaiser Permanente. My main location is at the ******************* location in Woodbridge, but I also frequented the Springfield and Tysons location for MRIs or doctor visits, and ***** to receive infusions for my illness. My illness is chronic and life-long. I was originally on infusions that took place every 4-6 weeks where I had a $30 copay. We fell behind on paying these medical bills as I had the copays billed. Was not working adequately at the time, and could not afford the medical payments. My father who is the insurance carrier from his place of employment, has me listed as one of his dependents and I have Kaiser through him. Because of the medical payments piling, my father spoke to the human resources and billing department of Kaiser in person, and informed them we need assistance. They agreed as my illness is life-long and I need numerous types of medication at a time. I am on many oral-pills as well as my main medication. I was told by a Kaiser worker from human resources and billing because of my condition and our income and all the other factors of my disability, Kaiser would place me in a program that renews every year where I do not pay for my medicine, any prescription, or my in-person visits (copays.) They stated I would be eligible and accepted, but need to renew the program every year. This year when I attempted to renew the program, even after they stated I would be eligible, they did not renew me. My body grew antibodies to the infusions I was initially in and I now do weekly injections that cost $25 a box. I am required to take them to keep my illness at a tolerable level. I cannot keep affording my medicine and in-person visits; I need Kaiser to re-enroll me in the program where I do not pay again. My illness is very much present and the expenses are eating at me.

  Business response

  03/24/2023

  The member applied for Medical Financial Assistance (MFA) in October 2022. The Health Plan mailed a letter to the member on October 12, 2022, requesting household proof of income. The member did not return any income information within 30 days, so her application was denied.
  
  The member is eligible to reapply again and can do so by visiting kp.org/mfa. She will need to provide proof of income for the entire household, as she indicated that there were 3 people in the household.
  
  The member was contacted on March 23, 2023, to provide the aforementioned information, but she could not be reached at the phone number we have listed.
  
  On behalf of the Health Plan, we apologize for any inconvenience this may have caused our valued member. We appreciate the opportunity to respond to and address her concerns.
  Please let me know if I can be of further assistance. 
  
  Thank you,
  
  Nika W****
  Member Retention Specialist
  
  

• Initial Complaint

  08/11/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  I needed a medication renewal. Doctor filled it out wrong. I received 3/6 items and was charged a high copay of $110 for a generic med. They will not give me the 3 I'm owed at No cost despite my doctor admitting to mistake. They said they called the pharmacy and that member services would need to fix. Member service says pharmacy needs to fix. Round and round we go.

• Initial Complaint

  07/26/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  I have only had this insurance for a couple of weeks and ever since i have had them they are complete joke. I been trying to get my prescription taken care of and all they do is keep giving it lies and gov e you the run around. I told them what the severity of the situation and that i needed my medication but they don’t a crap. Everyone in this company will not help you and they will send you to one department to another. So thanks to them i don’t have none of prescription/ medication. I want them to be investigated by the proper people. I will never recommend them to no one in the future because all they will do is screw you over and act like they care in which they don’t

• Initial Complaint

  06/24/2022

  Complaint Type:

  Product Issues

  Status:

  Unanswered

  More info

  In January 2022 Kaiser Permanente dropped me from my health insurance when all of my payments were up to date and paid in full. On 2/6/22 I made a payment of $240.00 and on 2/21/22 another payment of $222.46. I called the billing department the first week of March and explained the situation. I was approved for a refund of $462.46 and was told it would take 4-6 weeks for a check to come in the mail. When nothing arrived I called again on 4/28/22 and was told that administration had approved it recently and AGAIN I would receive a check in the mail for my refund in 4-6 weeks and I was given this confirmation #S355784892. My 5th and final call was on 5-16-22 when I spoke to a billing representative named ****** and she confirmed in her system that my refund had not been sent out yet but she did not know why because the money was approved and ready and she needed to speak to her superviser. She told me she would call me back and took my phone number. All I want is my refund for $462.46 and stop with the run around.

• Initial Complaint

  06/02/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Unresolved

  More info

  I *********************** (MRN #********** entered onto Kaiser's health plan through marriage (wife ******** ******'s policy) in 2018. I became really ill, required some procedures along with some medications. EVERYtime I go to the pharmacy to retrieve my medications there is a problem with my DOB. My DOB is ********, however, the system keeps changing my DOB back to an incorrect date. We have been trying to get this rectified by way of Kaiser for nearly 18 months (onset of my illness). I have created IT help desk tickets, I have worked with member services escalation team ************************* ************ or ************. There have been times where ******* would MANUALLY correct the DOB and then exactly a week later the system will revert back to the incorrect DOB. When this happens, I cannot get my medication at the pharmacy. This happened again today 6/2/22 - I am down to my last stomach pill (literally) and I was turned away! I am beyond disgusted with this process. As stated we have been dealing with this for so long that I can tell you my DOB has changed in the Kaiser System at least 109 times - and EVERY WEEK, regardless of who makes the updates, it changes back like clock work. No one at Kaiser is able to assist and this is impacting my health at this point, because when this happens I have to get out of the line (lose my place) go to Member Services, get them to change it (and depending on the time that I go) there office may not be open! I like Kaiser but I am truly tired of having to go through this and I need someone to fix it once and for all. If you look at the notes on my member services, you will see all parties involved that tried to help me rectify this issue (to no resolve). Its not fair and it needs to stop. Please help!

  Business response

  06/30/2022

  June 29, 2022 
  Greetings,  
  This letter is in response to your inquiry dated June 23, 2022 to Kaiser Foundation Health Plan of the  Mid-Atlantic States, Inc. (Health Plan), on behalf of the complainant. 
  We worked with our Membership Administration Team regarding the inquiry related to the member’s  date of birth being inaccurate in our system. The member has requested his date of birth to be corrected  to February 7, 1982. 
  The Membership Administration Team has reviewed the member’s concerns. Upon review, the  member’s date of birth has been corrected in our *** system, which has also updated in our Kaiser  Permanente Health Connect System. Member’s date of birth has been updated to reflect ******** **  ****. 
  Resolution: The Membership Administration Team has corrected the date of birth for *** ****** ***** effective June 23, 2022. I am pleased to inform you this concern has been resolved. It has been  recommended for the subscriber of the policy to contact their employer’s benefit administrator to have the  member’s date of birth updated on their eligibility file. 
  Sincerely, 
  Tanisha J****** 
  Member Retention Specialist 
  Georgia & Mid-Atlantic Markets 
  ###-###-#### 
  Kaiser Permanente
  
  

  Customer response

  07/01/2022

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: ********
  
  I am rejecting this response because:

  TODAY JULY 1- the exact same thing happened! My DOB in the Kaiser Network has reverted back to the incorrect date!  I am unable to get my pain medicine and we are approaching a holiday weekend. This is very upsetting to say the least! I am in a great deal of pain and am unable to get resolution.  The pharmacy will NOT release my medicine to me yet again !  While I appreciate your nicely written letter- THIS DID NOT FIX THE ISSUE!

  I am extremely upset. My wife left you a vm message as well for some resolution.

  Also, you mentioned the employer may be responsible for this error, which is not true! I have spoken with our HR group and my proper DOB has been confirmed since November 2021.

  
  

  Regards,
  
  ***********************
  

• Initial Complaint

  05/31/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  5/31/22-I receive a phone call from a debt collection agency stating I owe Kaiser $581.17. I ask how is this possible as I have this huge balance. I was referred back to Kaiser and when I spoke to someone in the financial department they stated that this bill is from multiple lab work between 2019-2020. I never received a bill. Verified my address and everything never received a bill. I asked could I settle this for $250, I was told ok but to call the debt collection agency back and make payment. Now the debt collection agency refused. I currently have Kaiser but these fees are ridiculous especially when I have never been notified from one bill.

  Business response

  06/22/2022

  June 21, 2022 
  To whomever it may concern:  
  This letter is in response to your inquiry dated June 13, 2022 to Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Health Plan), on behalf of the complainant. 
  We worked with our Patient Financial Services Department regarding the inquiry regarding charges in the  amount of $581.17 that was sent to **** Collections. 
  Patient Financial Services Department has reviewed the member’s charges that are in collections. There a  total of 20 transactions in collections ranging from date of services 3/21/2019 – 11/11/2021. Kaiser  Permanente Collection Policy states, members must receive 5 statements, prior to charges going to  collections. It has been confirmed that the member was sent via mail five statements for each transaction.  After review, the charges are valid that are with **** Collection Agency. Statements were sent to the  member via mail on the following dates: 04/06/2019; 05/06/2019; 06/05/2019; 07/06/2019; 08/05/2019;  09/04/2019; 10/05/2019; 11/04/2019; 12/04/2019; 01/04/2020; 03/18/2020; 04/18/2020; 05/19/2020;  06/20/2020; 07/21/2020; 12/20/2021; 01/22/2022; 02/21/2022; 03/23/2022.  
  Statements dated: 04/06/2019; 05/06/2019; 06/05/2019; 07/06/2019; 08/05/2019; 09/04/2019;  03/18/2020; 12/20/2021; 01/22/2022; 02/21/2022; 03/23/2022 were mailed to the following addresses that  was on file: **** *********** *****, Waldorf, MD *****.  
  Statements dated 10/05/2019; 11/04/2019; 12/04/2019; 01/04/2020; 04/18/2020; 05/19/2020; 06/20/2020;  07/21/2020 were mailed to the following address that was on file at this time: **** *** **** *****,  Waldorf, MD *****.  
  Resolution: The Patient Financial Services Department has confirmed the charges are valid. The  member was provided statements according to our Kaiser Permanente Collections Policy prior to being  sent to **** Collections Agency due to past-due balances. As a one-time courtesy, we have agreed to  pull the member’s charges from the **** Collections Agency. Member will have 7 calendar days to  contact the Patient Financial Services Department from the date of this letter to request a payment plan 
  
  for the balance. The member can contact the Patient Financial Services Department at 877-608-0077,  Monday – Friday, 7:30am – 9:00pm. 
  Sincerely, 
  Tanisha J.
  Member Retention Specialist 
  Georgia & Mid-Atlantic Markets 
  

• Initial Complaint

  04/14/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Unanswered

  More info

  I writing this complaint against my health ***************** Kaiser Permanente, From since last year i have been trying to get a colonoscopy follow check-up, I should be going back every 3yearsm It has been almost 4-years now. I have been paying them every month and cannot get an appointment. At first, it was covid and they said it was not critical. They actually send me a card to make the appointment and when i I call about two-weeks ago they said they don't have a anesthesiologist.. I don't know what else to do, this is my life and I am paying this insurance company every month and cannot get an appointment.

• Initial Complaint

  03/15/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  I would like to lead by stating that I am a Type 1 Diabetic and it is absolutely essential that I possess some form of health coverage, as it is a matter of life and death for me. I purchased a Kaiser Permanente health plan through Maryland Health Connection's marketplace in late December, (the plan went into effect Jan. 1st), giving my first payment towards the plan upon purchase. I then had received no instructions on making further payments, and received little to no communication regarding billing statements. My health plan was then canceled on March 4th with no prior warning, and I was not notified of its cancelation until 10 days later. I have reached out to both Kaiser Permanente and MD Health Connection to offer to pay the outstanding balance in full and reinstate my plan, but was told that I cannot have it reinstated, and must wait until November 15th, for the next open enrollment period. I was provided this denial after clearly communicating that I have Type 1 Diabetes and stressing the severity of the issue. I have filed a complaint to Kaiser Permanente to request further review for reinstatement, but I must stress that this is an issue of survival for me, due to my disability.

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